11D2175426 CLIA NUMBER - WALMART PHARMACY 10-0920

Laboratory Demographics

  • CLIA Code: 11D2175426
  • Facility Name: WALMART PHARMACY 10-0920
  • Facility Address: 3009 RUSSELL PARKWAY
    WARNER ROBINS, GA
    ZIP 31088
  • Facility Phone: 478 333-7026
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY MILLER
  • NPI Number: 1487033973
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175426
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0920
Street 3009 RUSSELL PARKWAY
City WARNER ROBINS
State GA
ZIP 31088
Phone 478 333-7026
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Pharmacy
Lab Director KELLY MILLER

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This page was last updated on: 9/29/2025